Interprofessional Collaboration Associated with Referrals to HIV Continuum of Care Services Among Marginalized Clients in Newark, New Jersey

Background and Purpose:  Throughout the United States, shrinking budgets have challenged community-based organizations (CBOs) to become more efficient, enhance quality of services they provide, and integrate services while competing for fewer resources. CBOs must collaborate to maximize the use of resources and better serve their clients. This is particularly evident in urban communities with high concentrations of people living with HIV and substance use disorders. The current study aimed to test if interprofessional collaboration is a significant predictor of referrals to HIV testing among substance use treatment and HIV prevention and treatment service providers.

Method: Community Based Participatory Research (CBPR) principles were used to conduct this research. Two community collaborative boards, one in New York City (NYC) and one in central New Jersey (NJ), joined together to conduct this research. A total of 142 providers and 15 administrators from 15 NJ CBOs agreed to complete a survey collected in person using DATSTAT software. Survey questions included provider demographic and agency information (e.g., number of staff, size of budget), standardized measures of interprofessional collaboration, involvement in research, implementation of evidence based interventions, questions about provider training (e.g., did you receive formal training on… [specific evidence based intervention]), and questions about past referral making (How many clients have you referred to HIV testing within the past 6 months?). A hierarchical multiple regression was conducted to determine if provider attitude and training (HIV treatment training, work satisfaction, attitudes about research and evidence based interventions), followed by self-reported frequency of collaboration with other agencies and attitudes about collaboration, improved the prediction of referral to HIV testing over and above agency and provider demographics.

Results: The full model tested was statistically significant, R² = .314, F (15,126) = 3.853, p < .000; adjusted R2 = .233. The addition of provider HIV training and attitudes about research and evidence based interventions to the prediction of referrals to HIV testing led to a statistically significant increase in R² of .070, F(4,128) = 2.772, p < .030. The addition of collaboration frequency and attitudes about collaboration to the prediction of referrals to HIV testing  also led to a statistically significant increase in R² of .119, F(2,126) = 10.974, p < .000. Providers who score higher endorsement of interprofessional collaboration and report engaging in collaboration reported significantly higher rates of referral to HIV testing.

Conclusions and Implications: Interprofessional collaboration is a significant predictor of referrals to HIV testing. Collaboration appears to maximize the use of scarce resources in times of shrinking funding. Further research is needed to consider strategies to maximize collaboration among HIV and substance use disorder treatment agencies serving marginalized populations.